Minerva anestesiologica
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Minerva anestesiologica · Apr 2020
Dextrose administration may reduce the incidence of postoperative nausea and vomiting after laporoscopic cholecystectomy: a double blind randomized controlled trial.
Pre-operative infusion of 5mL/kg of 5% dextrose before laparoscopic cholecystectomy reduces post-operative nausea & vomiting by ~30%.
pearl -
Minerva anestesiologica · Apr 2020
A noninvasive postoperative clinical score to identify patients at risk for postoperative pulmonary complications: the airtest score.
Postoperative pulmonary complications (PPCs) negatively affect morbidity, healthcare costs and postsurgical survival. Preoperative and intraoperative peripheral oxyhemoglobin saturation (SpO2) levels are independent risk factors for postoperative pulmonary complications (PPCs). The air-test assesses the value of SpO2 while breathing room-air. We aimed at building a clinical score that includes the air-test for predicting the risk for PPCs. ⋯ The simple, non-invasive and inexpensive bedside air-test score, evaluating pre- and postoperatively SpO2 measured on room-air, helps to predict the risk for PPCs.
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Advantages of propofol use in children may include less airway complications, less emergence agitation, and less postoperative behavioral changes. However, needle phobia and the complexity of total intravenous anesthesia set-up, as well as the pharmacokinetic and pharmacodynamic restrictions may limit the wide use of propofol-based anesthesia in the form of total intravenous anesthesia. ⋯ Propofol has earned its place as a valuable choice in pediatric anesthesia. In addition, propofol and inhalation anesthesia should not be looked at as mutually exclusive; a combination of both may sometimes be the best approach to complex clinical dilemmas.
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Minerva anestesiologica · Apr 2020
Randomized Controlled TrialThe Orogastric Tube Guide® as a novel strategy for gastric tube insertion: a prospective, randomized controlled clinical trial.
Gastric tube insertion, either orally or nasally, is daily practice in anesthesia and intensive care. "Blind" insertion represents the common conventional method and is associated with low first-pass success and frequent complications. This trial aimed to evaluate the novel gastric tube guide as a rigid conduit in regard to insertion success rate, time required and associated complications versus the conventional "blind" insertion method. We hypothesized that the insertion success rate is higher using the Orogastric tube guide. ⋯ Our findings suggest that the use of the GTG facilitates and fastens orogastric tube placement in anesthetized patients and thereby constitutes a benefit in clinical routine.
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Over the last 20 years, an increasing number of patients with multimorbidity and polypharmacy underwent different types of elective non-cardiac and cardiac surgery. Despite surgery is safer today than in the past, rate of perioperative major adverse cardiovascular events is still attracting significant attention from both clinicians and researchers. The perioperative myocardial infarction (PMI), a permanent damage of the heart, is a major cause of short- and long-term morbidity and mortality in current surgical populations. ⋯ These findings challenge our view of what may be feasible in terms of perioperative cardioprotection, despite technological limitations. Here, we will first analyze recent large-scale trials regarding current cardioprotective aids in non-cardiac and cardiac surgery. Finally, we will review novel cardioprotective targets translatable to surgical patients.